title: Functional characterization and multimodal imaging of treatment-naive "quiescent" choroidal neovascularization.
abstract: OBJECTIVE
  To investigate the multimodal morphological and functional characteristics of treatment-naïve "quiescent" choroidal neovascularization (CNV) secondary to AMD.
  
  
  METHODS
  Eleven patients with treatment-naïve "quiescent" CNV that consecutively presented over a 6-month period, underwent multimodal morphological and functional assessment (including indocyanine green angiography [ICGA], spectral-domain optical coherence tomography [SD-OCT], microperimetry, and preferential hyperacuity perimeter [PHP]). For the purpose of this study, asymptomatic previously untreated CNVs showing absence of intraretinal/subretinal exudation in two consecutive visits (at least 6 months apart) were defined as treatment-naïve "quiescent" CNV.
  
  
  RESULTS
  Eleven eyes of 11 patients (9 females; mean age 76.5 ± 8.5 years) were included. On fluorescein angiography (FA), "quiescent" CNVs appeared as late speckled hyperfluorescent lesions lacking well-demarcated borders. Mid-late phase ICGA allowed visualizing the hyperfluorescent "quiescent" CNV network and delineating the plaque. Mean lesion area (mid-late phase ICGA) appeared larger compared with earliest previous examination performed 23.8 ± 16.0 months before (3.24 ± 2.51 mm(2) vs. 3.52 ± 2.46 mm(2), respectively; P = 0.01). SD-OCT revealed, at the site of "quiescent" CNV, an irregularly slightly elevated RPE, without hyporeflective intraretinal/subretinal fluid, showing a major axis in the horizontal plane, which was characterized by collections of moderately reflective material in the sub-RPE space and clear visualization of the hyperreflective Bruch's membrane. Hypergeometric distribution revealed a significant correlation between microperimetry and PHP with respect to locations of "affected areas" (P = 0.001).
  
  
  CONCLUSIONS
  "Quiescent" CNVs are sub-RPE CNVs secondary to AMD, showing absence of intraretinal/subretinal exudation on repeated OCT. "Quiescent" CNVs enlarge over time and may contribute to local reduced retinal sensitivity and metamorphopsia.
authors.affiliation: Department of Ophthalmology, University of Paris Est Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Mayer
authors.initials: M
authors.lastname: Srour
authors.forename: Nathalie
authors.initials: N
authors.lastname: Massamba
authors.forename: Anouk
authors.initials: A
authors.lastname: Georges
authors.forename: Naima
authors.initials: N
authors.lastname: Ben Moussa
authors.forename: Omer
authors.initials: O
authors.lastname: Rafaeli
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests / Q000379:methods
chemical_list: D007208:Indocyanine Green
keywords: age-related macular degeneration; choroidal neovascularization; fluorescein angiography; indocyanine angiography; microperimetry; preferential hyperacuity perimeter; quiescent; scanning laser ophthalmoscopy; spectral-domain optical coherence tomography